慢性淋巴性甲状腺炎与甲状腺乳头状癌之间的关系:手术标本研究的系统回顾和荟萃分析

Q4 Medicine Revista Colombiana de Cirugia Pub Date : 2022-12-23 DOI:10.30944/20117582.2228
Carlos Osorio-Covo, Jorge Ballestas-Barrera, Juan Correa-Palacio, Valeria Zambrano-Pacheco, Angie Rosales-Becerra, William Camargo-Martínez, Diego Barrios-Castellar, David Ortega-Caballero, Francisco Herrera-Sáenz
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引用次数: 0

摘要

介绍。关于手术标本中伴有慢性淋巴细胞性甲状腺炎变化的甲状腺乳头状癌(PTC)的可能性增加的假设陈述,文献中存在不一致的结果。现有的荟萃分析包括了在方法学上没有可比性的研究,也没有提出明确的偏倚来源,因此,这是本荟萃分析的理由。在PubMed和Embase中检索1950年1月1日至2020年12月31日的文献。回顾性研究比较了慢性淋巴细胞性甲状腺炎和非慢性淋巴细胞性甲状腺炎标本中甲状腺乳头状癌的患病率。对收集到的证据进行统计学分析。共纳入22篇文章。研究人群包括63548例手术标本。基于这些研究,合并OR为1.81 (95% CI: 1.51-2.21)。各研究中患病率和机会比的分布存在异质性(I²= 91%;p > 0.00001)。分析中纳入的研究的漏斗图形状似乎是对称的,表明不存在可归因于小研究的偏倚。目前的文献表明,在观察到慢性淋巴细胞性甲状腺炎相容变化的手术标本中,记录甲状腺乳头状癌的风险增加;然而,在回顾性研究中存在无法控制的偏倚来源,因此我们建议研究这样一种假设,即使用前瞻性方法在慢性淋巴细胞性甲状腺炎相容改变的标本中诊断PTC的可能性增加。
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Association between chronic lymphocityc thyroiditis and papillary thyroid carcinoma: Systematic review and meta-analysis of studies on surgical specimens
Introduction. Inconsistent results exist in the literature regarding the hypothesis statement suggesting an increased likelihood of documenting papillary thyroid carcinoma (PTC) in surgical specimens with changes compatible with chronic lymphocytic thyroiditis. Existing meta-analyses have included studies that are not methodologically comparable and do not propose clear sources of bias, thus, this is justification for the present meta-analysis. Methods. A literature search in PubMed and Embase was performed from January 1, 1950 to December 31, 2020. Retrospective studies comparing the prevalence of papillary thyroid carcinoma in specimens with and without chronic lymphocytic thyroiditis changes were obtained. The collected evidence was statistically analyzed. Results. A total of 22 articles were included. The study population consisted of 63,548 surgical specimens. The pooled OR, based on the studies, was 1.81 (95% CI: 1.51-2.21). There was heterogeneity between the distribution of prevalence ratios and opportunity ratios across studies (I²= 91%; p>0.00001). The funnel plot shape of the studies included in the analysis appears to be symmetrical, indicating the absence of bias attributable to small studies. Conclusions. The current literature suggests that there is an increased risk of documenting papillary thyroid carcinoma in surgical specimens in which chronic lymphocytic thyroiditis-compatible changes are observed; however, there are sources of bias that will not be possible to control for in retrospective studies, so we recommend studying the hypothesis suggesting an increased likelihood of diagnosing PTC in specimens with chronic lymphocytic thyroiditis-compatible changes using prospective methodologies.
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61
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36 weeks
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